HIV-positive patients and Hepatitis screening

By: Marcus Hopkins, HEAL blogger

HIV / HCV Co-Infection

HIV/HCV Co-Infection

One of the worst diagnoses a person can receive is that they have tested positive for HIV. Once you’ve received that information, it is all but guaranteed that your life will change. When I tested Positive, my first concern wasn’t that I was going to die – it was making sure that I didn’t contract anything else. The sad reality, however, is that a good rule of thumb for healthcare professionals is, “If they’ve been exposed to one [STD/STI], they’ve very likely been exposed to another.”

HIV and Hepatitis C coinfection is a growing problem, not only in the United States, but across the globe. The CDC estimates that roughly 1/3 of people living with HIV are currently coinfected with either Hepatitis B or Hepatitis C, with more people infected with HCV than HBV. More shockingly to me, however, was the fact that liver disease – much of which is related to HCV and HBV – has become the leading cause of non-AIDS-related deaths in people living with HIV.

But, is enough attention being paid to the risk of coinfection in our community? Demonstrably, no. So the question then becomes, “How do we raise awareness within the health provider and educator communities to communicate this information to their patients and class member?”

Once again, there are no easy answers; and, as with trying to get patients to comply with their treatment regimens, the biggest challenge is compliance. When treating patients, you’re already in an emotionally sensitive and time-sensitive situation – asking a doctor or nurse to provide additional information takes time away seeing other patients, but it is vital that this information be communicated.

More important is the need for testing. HIV+ patients are current not routinely screened for HCV, even though we now have rapid testing available. That, in my opinion, is unconscionable. In my own experience, I have been screened for it several times, in numerous states (FL, TN, CA, and WV) over the past seven years, and have thankfully come up negative with each test, but that does not mean that I should not remain vigilant. It does, however, mean that my healthcare providers were consistently providing adequate care and doing their due diligence to ensure that I was properly equipped with the tools I needed to adequately manage my own condition.

Further to that point, we, as educators, are not doing our own due diligence to make sure that information about HCV is reaching at-risk populations. As I mentioned before, HBV and HCV ostensibly account for many of the non-AIDS-related deaths in the HIV community; despite this information, the importance of regular Hepatitis screening and the possible need for fast and immediate treatment are not part of the daily conversation in the HIV+ community. How can we possibly express the severity of the issue if we, ourselves, are not actively participating in the process?

Going forward, we need to ensure that healthcare providers are pushing testing for HBV and HCV, if only because it provides them with more information that can guide how providers approach treatment. Knowing which medications to prescribe in order to accommodate the additional strain put on the liver is paramount in ensuring that the Hepatitis virus is controlled in addition to treating HIV.

So, how do we do this? That’s where the easy solutions end. Getting healthcare providers and educators to disseminate this information is a process, and one that takes time to put into place; ensuring that they comply with that process is just another step that requires diligence and consistency, and at current staffing levels, it’s not quite clear whether or not we can live up to any new standards.

As far as an information campaign is concerned, we need to insure that whatever information is available is compiled in a way that is easy both to find and to understand if we’re ever to overcome the education barriers that stand between HIV patients and understanding the risk of coinfection. As an educator, even I have trouble finding credible information from reliable sources, which points to a lack of cooperation between organizations that needs to be addressed in the near future. We need to pool our resources, rather than allowing each organization to do its own thing. While some may argue that centralizing the education effort reduces the number of options healthcare consumers have when deciding upon treatment methods, the crisis we face requires that we bite the figurative bullet and get it together in order to better serve a population desperately in need of outreach.

Disclaimer: HEAL Blogs do not necessarily reflect the views of the Community Access National Network (CANN), but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about Hepatitis-related issues and updates.

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